Beckmann Nicholas A, Bitsch Rudi G, Seeger Joern B, Klotz Matthias Cm, Kretzer Jan Philippe, Jaeger Sebastian
Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery , University of Heidelberg , Heidelberg.
Acta Orthop. 2014 Sep;85(5):531-7. doi: 10.3109/17453674.2014.919557. Epub 2014 May 5.
Revision arthroplasty often requires anchoring of prostheses to poor-quality or deficient bone stock. Recently, newer porous materials have been introduced onto the market as additional, and perhaps better, treatment options for revision arthroplasty. To date, there is no information on how these porous metals interface with bone cement. This is of clinical importance, since these components may require cementing to other prosthesis components and occasionally to bone.
We created porous metal and bone cylinders of the same size and geometry and cemented them in a well-established standardized setting. These were then placed under tensile loading and torsional loading until failure was achieved. This permitted comparison of the porous metal/cement interface (group A) with the well-studied bone/cement interface (group B).
The group A interface was statistically significantly stronger than the group B interface, despite having significantly reduced depth of cement penetration: it showed a larger maximum tensile force (effect size 2.7), superior maximum tensile strength (effect size 2.6), greater maximum torsional force (effect size 2.2), and higher rotational stiffness (effect size 1.5).
The newer porous implants showed good interface properties when cemented using medium-viscosity bone cement. The axial and rotational mechanical strength of a porous metal/cement interface appeared to be greater than the strength of the standard bone/cement interface. These results indicate that cementing of porous implants can provide great stability in situations where it is needed.
翻修关节成形术通常需要将假体固定于质量差或骨量不足的骨组织上。最近,新型多孔材料已投放市场,作为翻修关节成形术的额外且可能更好的治疗选择。迄今为止,尚无关于这些多孔金属与骨水泥如何结合的信息。这具有临床重要性,因为这些部件可能需要与其他假体部件以及偶尔与骨进行骨水泥固定。
我们制作了尺寸和几何形状相同的多孔金属圆柱体和骨圆柱体,并在成熟的标准化环境中将它们用骨水泥固定。然后将其置于拉伸载荷和扭转载荷下直至失效。这使得能够将多孔金属/骨水泥界面(A组)与已充分研究的骨/骨水泥界面(B组)进行比较。
A组界面在统计学上显著强于B组界面,尽管骨水泥渗透深度显著降低:它显示出更大的最大拉伸力(效应大小为2.7)、更高的最大拉伸强度(效应大小为2.6)、更大的最大扭转力(效应大小为2.2)以及更高的旋转刚度(效应大小为1.5)。
使用中粘度骨水泥进行骨水泥固定时,新型多孔植入物显示出良好的界面特性。多孔金属/骨水泥界面的轴向和旋转机械强度似乎大于标准骨/骨水泥界面的强度。这些结果表明,在需要的情况下,多孔植入物的骨水泥固定可提供很大的稳定性。